A long-term follow-up of patients with Meniere's disease--comparative study of unilateral and bilateral Mènière's disease

Abstract

A retrospective study was carried out on 46 patients with Meniere's disease (MD). Twenty of them were followed up for 20-40 years (long-term follow-up cases), and 26 of them for 5-12 years (middle-term follow-up cases). Thirteen of the patients suffered from fluctuating sensorineural hearing loss in one ear (unilateral MD), and 33 of them suffered from it in both ears (bilateral MD). Comparing the results of repeated audio-vestibular examinations of patients with unilateral MD with those of patients with bilateral MD revealed the following differences between them: 1) The range of fluctuation of the hearing level of the patients with unilateral MD was greater than that of the patients with bilateral MD. 2) Most patients with unilateral MD showed three audiometric configurations, but most patients with bilateral MD showed two audiometric configurations during the first 5 years of the follow-up period. 3) The patients with unilateral MD showed unilateral weakness on the caloric test more often than the patients with bilateral MD. But other clinical features in the patients with unilateral MD and those with bilateral MD were similar. We confirmed that there was an increase in bilaterality with time, but it is impossible to speculate whether the patients with unilateral MD will also suffer it in the contralateral ear or not. Therefore, it is possible that in all patients who have suffered from unilateral MD for a long time the disease may become bilateral in the future. Clinical observation of patients with MD as long as possible is the only way to clarify the relationship between unilateral and bilateral MD. It is stressed that to gain the patient's confidence is not only the basis of long-term follow-up of the patient, but also of effective treatment of MD.